Welcome to the Podiatry Blog of Dr Richard Blake of San Francisco. I hope that the information here will help you in some way. Please feel free to leave a comment on the blog, or email me questions at drblakeshealingsole@gmail.com. If the blog helps you, consider a $5 donation to keep the blog growing. $25 has been donated in March 2018. Thank you. Dr Rich Blake

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Sunday, June 19, 2011

Taping for Posterior Tibial Tendon Dysfunction/Tendinitis

This video presents the use of 2 inch Kinesiotape to help support the arch relaxing the pull of the posterior tibial tendon. The various injuries associated with over pronation and the posterior tibial tendon are helped with this taping technique. The injuries include (although not exclusive): posterior or medial shin splints, posterior tibial tendinitis, os tibial externum syndrome, arch strain, and tibial stress fractures. This form of taping is a common adjunct to stable shoes, orthotic devices, and power lacing. For those of you unfamiliar with power lacing, the video below shows this powerful stabilizing technique.

3 comments:

Hi Doc my injury is complicated and results from 16 major surgeries after complete loss of 22cm off my tibia. Two years ago I had a fibula/tibia transplant to support the tibia but still on one crutch I can walk without the crutch but with much pain within the tibia which has an expanding intra-medullary nail but mostly I believe my disability continues to be more out of fear than real physical pain and after 13 years on crutches the fear is overwhelming. What can I do to walk crutch free? Thanks Sylvia from Nairobi, Kenya

HEEL PAIN OR PLANTAR FASCIITIS- WHAT REALLY CAUSES IT AND WHAT REALLY IS THE BEST NEW TREATMENTS FOR 2017?

When we stood up on our back feet, several million years ago, we put a lot of new pressure in the heel area of the foot. HEEL PAIN OR PLANTAR FASCIITIS- is the number one problem in the human foot.

what is the cause? A bone spur that your doctor may see on a lateral x-ray of your foot?The wrong shoe? Am injury to the heel?

None of the above. It basically is the 'pull' of the cord on the bottom of the foot back in the area where it attaches to the heel bone. The syndrome is basically the results of a "TUG OF WAR" along the arch of the foot. Every time the foot purchases the ground- the cord become taught. The pull along the heel area sets up an inflammation process that calls inflammatory cells to the area, hence putting pressure on the local 'nerves'- creating the heel pain.

The best treatment is to hold up the foot and plantar fascia, so the foot cannot stretch (pronate) every time it hits the ground. 1000 times a mile when running and probably about 1500 times a mile when walking.

The WRONG ways of treating this MOST common problem in the human foot:

1. NIGHT SPLINTS -you cannot stretch the plantar fascia. NIGHT SPLINTS do not stretch the fascia at all. It is like a very strong fibrous cord. The reason wearing the night splint overnight makes it feel better in the morning- is that is simply is applying pressure to the area and disallows swelling around the heel at night. No swelling- less heel pain when you get up on it in the morning. But it does not stretch the fascia. Ice in the morning to 3 minutes will help too, but not cure.2. STRETCHING- Doctors and therapist love to stretch the plantar fascia for you. Worst thing that you can do when the heel is painful. This just increases the pain and lengthens the syndrome. No stretching. 3. INCREASING ACTIVITIES & SPORTS- Very bad thing. During the pain period you need to find an athletic activity that take you essentially off you fee. Upper body work in the gym,swimming, biking. As long as it isnt on your fee. And you cant return to 'on foot' exercise until there is NO heel pain.

The best treatments known to medicine in 2017:

1. CUSTOM ORTHOTIC- not the harder plastic types of orthotics. Too much pressure on the inflamed heel area. Why walk on a hard piece of plastic. Would you buy a pair of hard plastic shoes? The orthotic should be made of firm rubber materials. Not just rubber on the bottom of the device, buts softer rubbers top to bottom. The orthotic stops the foot from stretching (pronating) hence the tight pull in the plantar fascia is eliminated. You should wear the soft custom orthotic all the time.2. EXTRA CORPORAL SOUND WAVES ECSW: This is a modality discovered by German doctors to break up kidney stones right thru the skin with high energy sound waves. We later realized that ECSW treatments seem to speed up the healing of plantar fasciitis. Maybe then is stretches a bit.3. CORTISONE INJECTION: I believe in just one at the time of the first treatment of heel pain. Seems to calm things sometimes in the right direction.4. TAPING: Before the doctor's custom soft orthotics it a a great thing to do what the orthotics will eventually do for the fascia- hold it up and disallow the pronation or pull on the cord.5. OFF ALL ONFOOT ACTIVITIES: As much as possible no runs, long walks, even limit standing until there is no more pain.6. CASTING THE FOOT AND LEG: If all of the above fails- have your doctor put your foot in a fiberglass cylinder cast for 3-6 weeks. It is a bit drastic, but it can save you from the surgery which should be avoided at all costs.

You really want to get rid of your heel pain. Stick with a podiatrist who goes by my 1-6 best treatments and you have a 95% chance of curing and returning to all the things you want to do within 2-4 months.

Thank you very much for leaving a comment. Due to my time restraints, some comments may not be answered.I will answer questions that I feel will help the community as a whole.. I can only answer medical questions in a general form. No specific answers can be given. Please consult a podiatrist, therapist, orthopedist, or sports medicine physician in your area for specific questions.

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About Me

I have been a podiatrist for 34 years now and I am excited about sharing what I have learned on this blog. I love to exercise, especially basketball and hiking. I love to travel. I am very happily married to Patty, and have 2 wonderful sons Steve and Chris, a great daughter in law Clare, my new grandson Henry, and a grand dog Felix.